The frequency of thrombocytopenia in neonates born to mother with immune thrombocytopenia is low1. Mild to moderate thrombocytopenia is a common presentation3. About 1-5% of neonates will have platelet count less than 20,000/µl and about 1% have significant bleeding. In our case report the first twin born to mother with immune thrombocytopenia is described. The mother was diagnosed as ITP at 32 week of gestational age. The platelet count done on 2nd hour of life showed 90,000/µl. The lowest platelet count reported in this child is 8000/µl on postnatal day 3.The neonate received platelet transfusion and immunoglobin3. Although neonatal thrombocytopenia associated with ITP is usually mild, some neonates have severe thrombocytopenia for several days following life.